Changing epidemiology of CDAD
Not only is the incidence of CDAD increasing but there have been several reports of outbreaks in healthcare facilities and the community caused by a new strain of C. difficile throughout North America.(5-11) This new strain has the ability of producing a binary toxin [it is unclear what role this plays relative to morbidity and mortality] and in quantities that are 16 and 23 times higher for toxin A and B respectively, than prior strains.(7) Further this new strain(s) causes greater morbidity – in some cases requiring colectomy – and increased mortality, especially among those over 65.(12)